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"Fast Track" AND "Emergency"

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https://www.readbyqxmd.com/read/30333450/-should-i-stay-or-should-i-go-patient-who-leave-emergency-department-of-an-italian-third-level-teaching-hospital
#1
Alberto Carli, Francesca Moretti, Giulia Giovanazzi, Valentina Niero, Valeria Perilli, Giovanna Ghirlanda, Chiara Bovo, Stefano Tardivo
BACKGROUND AND AIM: Patients could leave ED not receiving the desired care either Without Being Seen by a doctor (LWBS) or Against Medical Advice (DAMA). In term of care quality, LWBS may be related to inappropriate access and process of care, while DAMA may lead to increased risk of mortality and re-admissions. This study aims to identify frequency of patients who leave ED, determine their characteristics and identify associated factor. METHODS: This was a retrospective observational study of patients that attended EDs of University Hospital Trust of Verona in 2017...
October 8, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/30297138/patients-experiences-during-the-first-12-weeks-after-discharge-in-fast-track-hip-and-knee-arthroplasty-a-qualitative-study
#2
Kirsten Specht, Hanne Agerskov, Per Kjaersgaard-Andersen, Rebecca Jester, Birthe D Pedersen
BACKGROUND: Due to the shortened length of stay in fast-track total hip and knee arthroplasty, patients must at a very early stage following surgery take responsibility for their postoperative care and treatment. It is important to establish if this treatment modality of fast-track is not only cost-effective, but meets patients' expectations and needs. AIM: To explore the lived experience of patients in fast-track total hip and knee arthroplasty during the first 12 weeks after discharge...
August 24, 2018: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/30263856/building-on-the-shoulders-of-giants-is-the-use-of-early-spontaneous-ventilation-in-the-setting-of-severe-diffuse-acute-respiratory-distress-syndrome-actually-heretical
#3
REVIEW
Fabrice Petitjeans, Cyrille Pichot, Marco Ghignone, Luc Quintin
Acute respiratory distress syndrome (ARDS) is not a failure of the neurological command of the ventilatory muscles or of the ventilatory muscles; it is an oxygenation defect. As positive pressure ventilation impedes the cardiac function, paralysis under general anaesthesia and controlled mandatory ventilation should be restricted to the interval needed to control the acute cardio-ventilatory distress observed upon admission into the critical care unit (CCU; "salvage therapy" during "shock state")...
September 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/30226494/-seguridad-y-eficacia-del-modelo-de-atenci%C3%A3-n-fast-track-vs-atenci%C3%A3-n-convencional-en-apendicitis-no-complicada-del-paciente-pedi%C3%A3-trico
#4
Alberto Tlacuilo-Parra, Sandy P López-Valenzuela, Gabriela Ambriz-González, Elizabeth Guevara-Gutiérrez
Objetivo: Comparar la seguridad y la eficacia de la atención fast-track vs. atención convencional en apendicitis no complicada en un hospital pediátrico. Método: Ensayo clínico controlado, aleatorizado, con dos grupos de 30 pacientes cada uno: A) fast-track, apendicitis no complicada que cumplieron el programa; y B) atención convencional, apendicitis no complicada con atención habitual. Variables de seguridad y eficacia: proporción de complicaciones y tiempo de estancia hospitalaria...
2018: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/30146038/epidemiology-outcomes-and-management-of-acute-kidney-injury-in-the-vascular-surgery-patient
#5
REVIEW
Charles Hobson, Nicholas Lysak, Matthew Huber, Salvatore Scali, Azra Bihorac
OBJECTIVE: Conventional clinical wisdom has often been nihilistic regarding the prevention and management of acute kidney injury (AKI), despite its being a frequent and morbid complication associated with both increased mortality and cost. Recent developments have shown that AKI is not inevitable and that changes in management of patients can reduce both the incidence and morbidity of perioperative AKI. The purpose of this narrative review was to review the epidemiology and outcomes of AKI in patients undergoing vascular surgery using current consensus definitions, to discuss some of the novel emerging risk stratification and prevention techniques relevant to the vascular surgery patient, and to describe a standardized perioperative pathway for the prevention of AKI after vascular surgery...
September 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/30127665/patient-satisfaction-with-prehospital-emergency-care-following-a-hip-fracture-a-prospective-questionnaire-based-study
#6
Glenn Larsson, Ulf Strömberg, Cecilia Rogmark, Anna Nilsdotter
Background: Older patients with a hip fracture require specialized emergency care and their first healthcare encounter before arriving at the hospital is often with the ambulance service. Since 2005 there has been a registered nurse on the crew of every ambulance in Sweden in order to provide prehospital emergency care and to prepare the patients for hospitalization. It is important to investigate patient satisfaction with prehospital emergency care following a hip fracture to ensure that their expectations of good care are met...
2018: BMC Nursing
https://www.readbyqxmd.com/read/30093379/interventions-to-improve-patient-flow-in-emergency-departments-an-umbrella-review
#7
Loren De Freitas, Steve Goodacre, Rachel O'Hara, Praveen Thokala, Seetharaman Hariharan
OBJECTIVES: Patient flow and crowding are two major issues in ED service improvement. A substantial amount of literature exists on the interventions to improve patient flow and crowding, making it difficult for policymakers, managers and clinicians to be familiar with all the available literature and identify which interventions are supported by the evidence. This umbrella review provides a comprehensive analysis of the evidence from existing quantitative systematic reviews on the interventions that improve patient flow in EDs...
October 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/30086613/recent-research-trends-and-updates-on-nonalcoholic-fatty-liver-disease
#8
Jeong-Ju Yoo, Won Kim, Moon Young Kim, Dae Won Jun, Sang Gyune Kim, Jong-Eun Yeon, Jin Woo Lee, Yong Kyun Cho, Sang Hoon Park, Joo Hyun Sohn
Nonalcoholic fatty liver disease (NAFLD), together with metabolic syndrome and obesity, has shown a rapid increase in prevalence worldwide and is emerging as a major cause of chronic liver disease and liver transplantation. Among the various phenotypes of NAFLD, nonalcoholic steatohepatitis (NASH) is highly likely to progress to development of end-stage liver disease and cardiometabolic disease, resulting in liver-related and non-liver-related mortality. Nonetheless, there is no standardized pharmacotherapy against NASH and many drugs are under development in ongoing clinical trials...
August 8, 2018: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/30078854/comparison-of-bispectral-index-and-end-tidal-anaesthetic-concentration-monitoring-on-recovery-profile-of-desflurane-in-patients-undergoing-lumbar-spine-surgery
#9
R Sudhakaran, Jeetinder K Makkar, Divya Jain, Jyotsna Wig, R Chabra
Background and Aims: Several techniques have evolved over time to monitor depth of anesthesia and ensure enhanced recovery. This randomized double-blinded trial was designed to compare bispectral index (BIS) or end-tidal anaesthetic concentration (ETAC) monitoring on the recovery characteristics of patients undergoing thoracolumbar spine surgeries. Methods: Seventy American Society of Anesthesiologist I-II patients of either sex were randomized to Group B - BIS-guided protocol, Group E - ETAC-guided protocol, or Group S - Standard protocol...
July 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30059375/interdisciplinary-design-to-improve-fast-track-in-the-emergency-department
#10
Carol Anne Celona, Andrew Amaranto, Robin Ferrer, Matt Wieland, Stacy Abrams, Farley Obusan, Sharon LoPuzzo, Valsamma Joy
Delays in medical care will increase risks for patients. For this reason, timeliness of care is a public health priority and the one of the missions for this facility. The goal of this process improvement project was to enhance timeliness of care by restructuring fast track. Door-to-provider time, treat and release time, and the number of patients who left without being seen by a provider were monitored. Nurse practitioners were introduced into advanced practice provider mix and the development of care teams was implemented...
July 2018: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/30021751/patient-tailored-triage-decisions-by-anaesthesiologist-staffed-prehospital-critical-care-teams-a-retrospective-descriptive-study
#11
Morten Langfeldt Friberg, Leif Rognås
OBJECTIVES: The primary objective was to estimate the incidence of patients in the Central Denmark Region triaged to bypass the local emergency department without being part of a predefined fast-track protocol. The secondary objective was to describe these triage decisions in more detail with regard to the most common diagnoses, incidence of direct referral sorted by the prehospital critical care team (PHCCT) and the destination hospital. DESIGN: Retrospective descriptive study...
July 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/29977239/the-us-military-commitment-to-vaccine-development-a-century-of-successes-and-challenges
#12
REVIEW
Silvia Ratto-Kim, In-Kyu Yoon, Robert M Paris, Jean-Louis Excler, Jerome H Kim, Robert J O'Connell
The US military has been a leading proponent of vaccine development since its founding. General George Washington ordered the entire American army to be variolated against smallpox after recognizing the serious threat that it posed to military operations. He did this on the recommendation from Dr. John Morgan, the physician-in-chief of the American army, who wrote a treatise on variolation in 1776. Although cases of smallpox still occurred, they were far fewer than expected, and it is believed that the vaccination program contributed to victory in the War of Independence...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29953101/-fast-track-rehabilitation-in-perforated-duodenal-ulcer
#13
A I Khripun, I V Sazhin, S N Shurygin, G B Makhuova
AIM: To analyze the outcomes of fast track rehabilitation program in patients with perforated duodenal ulcer (PDU). MATERIAL AND METHODS: For the period 2013-2016 at the Department of Surgery and Endoscopy 206 PDU patients have been treated. Inclusion criterion for the main group (n=77) was duodenal ulcers, their dimension up to 1 cm, laparoscopic suture of perforated ulcer, fast track rehabilitation program implementation. The control group consisted of 129 patients who underwent open suturing of perforated ulcer followed by conventional treatment in postoperative period...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29929886/the-experiences-of-pre-and-in-hospital-care-in-patients-with-hip-fractures-a-study-based-on-critical-incidents
#14
Bodil Ivarsson, Ami Hommel, Magnus Sandberg, Desirée Sjöstrand, Anders Johansson
BACKGROUND: Hip fractures are described to have a significant impact on patients' well-being and different fast-track concepts could result in a reduction of the patient's psychological and emotional reactions before pre- and intrahospital care. AIMS AND OBJECTIVES: This study aimed to elucidate perceived situations of significance experienced by patients with hip fracture during the prehospital- and in-hospital care. DESIGN: The study used a qualitative approach using a critical incident technique (CIT), 14 patients with hip fractures were included...
August 2018: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/29905758/short-stay-unit-hospitalisation-vs-standard-care-outcomes-in-older-internal-medicine-patients-a-randomised-clinical-trial
#15
Camilla Strøm, Lars Simon Rasmussen, Anne-Sophie Löwe, Anne Kathrine Lorentzen, Nicolai Lohse, Kim Hvid Benn Madsen, Søren Wistisen Rasmussen, Thomas Andersen Schmidt
Background: the effect of hospitalisation in emergency department-based short-stay units (SSUs) has not been studied in older patients. We compared SSU hospitalisation with standard care at an Internal Medicine Department (IMD) in acutely admitted older internal medicine patients. Methods: pragmatic randomised clinical trial. We randomly assigned patients aged 75 years or older, acutely admitted for an internal medicine disease and assessed to be suitable for SSU hospitalisation to SSU hospitalisation or IMD hospitalisation...
June 13, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29847313/exploring-and-improving-student-engagement-in-an-accelerated-undergraduate-nursing-program-through-a-mentoring-partnership-an-action-research-study
#16
Marguerite Bramble, Hazel Maxwell, Rochelle Einboden, Sally Farington, Richard Say, Chin Liang Beh, Grace Stankiewicz, Graham Munro, Esther Marembo, Greg Rickard
This Participatory Action Research (PAR) project aimed to engage students from an accelerated 'fast track' nursing program in a mentoring collaboration, using an interdisciplinary partnership intervention with a group of academics. Student participants represented the disciplines of nursing and paramedicine with a high proportion of culturally and linguistically diverse (CALD) students. Nine student mentors were recruited and paired with academics for a three-month 'mentorship partnership' intervention. Data from two pre-intervention workshops and a post-intervention workshop were coded in NVivo11 using thematic analysis...
May 30, 2018: International Journal of Nursing Education Scholarship
https://www.readbyqxmd.com/read/29751212/sustainable-vaccine-development-a-vaccine-manufacturer-s-perspective
#17
REVIEW
Rino Rappuoli, Emmanuel Hanon
Vaccination remains the most cost-effective public health intervention after clean water, and the benefits impressively outweigh the costs. The efforts needed to fulfill the steadily growing demands for next-generation and novel vaccines designed for emerging pathogens and new indications are only realizable in a sustainable business model. Vaccine development can be fast-tracked through strengthening international collaborations, and the continuous innovation of technologies to accelerate their design, development, and manufacturing...
May 8, 2018: Current Opinion in Immunology
https://www.readbyqxmd.com/read/29742626/delta-alert-expanding-gerotrauma-criteria-to-improve-patient-outcomes-a-2-year-study
#18
Lynn L Wiles, Mark D Day
BACKGROUND/SIGNIFICANCE: Because of their decreased physical reserve and increased risk of complications, the geriatric trauma patient (GTP) population warrants heightened awareness by clinical staff. PURPOSE: The purpose of this study is to determine whether the institution of a third-tier trauma protocol results in a change in GTP outcomes, complications, and mortality rates. METHODS: Researchers conducted a retrospective review of 2 years of data from the trauma registry, hospital quality improvement audits, and patient charts to examine what, if any, patient outcomes were impacted by the institution of the expanded GTP protocol...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29738285/futsal-task-constraints-promote-transfer-of-passing-skill-to-soccer-task-constraints
#19
Luca Oppici, Derek Panchuk, Fabio Rubens Serpiello, Damian Farrow
This study investigated how learning a passing skill with futsal or soccer task constraints influenced transfer to a new task. Futsal (n = 24, 13.6 ± 1.2 years old, 7.0 ± 1.6 years of experience) and soccer (n = 24, 13.6 ± 1.2 years old, 6.8 ± 1.2 years of experience) players performed two 5v5 + goalkeeper modified games - a futsal-like task (small playing area with the futsal ball) and soccer-like task (large playing area with the soccer ball). Participants' passing accuracy and their orientation of attention were assessed during the two tasks...
August 2018: European Journal of Sport Science
https://www.readbyqxmd.com/read/29608170/multiplexed-isothermal-amplification-based-diagnostic-platform-to-detect-zika-chikungunya-and-dengue-1
#20
Ozlem Yaren, Barry W Alto, Kevin M Bradley, Patricia Moussatche, Lyudmyla Glushakova, Steven A Benner
Zika, dengue, and chikungunya viruses are transmitted by mosquitoes, causing diseases with similar patient symptoms. However, they have different downstream patient-to-patient transmission potentials, and require very different patient treatments. Thus, recent Zika outbreaks make it urgent to develop tools that rapidly discriminate these viruses in patients and trapped mosquitoes, to select the correct patient treatment, and to understand and manage their epidemiology in real time. Unfortunately, current diagnostic tests, including those receiving 2016 emergency use authorizations and fast-track status, detect viral RNA by reverse transcription polymerase chain reaction (RT-PCR), which requires instrumentation, trained users, and considerable sample preparation...
March 13, 2018: Journal of Visualized Experiments: JoVE
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